The following is a summary of “SVEAT score: Acute chest pain risk stratification,” published in the June 2024 issue of Emergency Medicine by Gol, et al.

For a study, researchers sought to compare the predictive accuracy of the newly introduced Symptoms, Vascular disease history, Electrocardiography, Age, and Troponin (SVEAT) score with the widely utilized History, ECG, Age, Risk factors, and Troponin I (HEART) score in stratifying the risk of 30-day major adverse cardiac events (MACE) among patients presenting with acute chest pain in the emergency department.

They conducted a prospective, observational study at a tertiary care hospital’s emergency department between June 2022 and January 2023. Adult patients aged 24 years and older presenting with non-traumatic chest pain were enrolled. Inclusion criteria comprised chest pain lasting more than 5 minutes, while exclusion criteria included STEMI, pregnancy, traumatic chest pain, and lack of 30-day MACE data. Each participant’s HEART and SVEAT scores were calculated to assess their respective predictive performances in identifying low-risk patient groups.

Among the 809 patients included, the SVEAT score categorized 589 (72.8%) as low-risk compared to 377 (46.6%) by the HEART score. Of these patients, 115 (14.2%) experienced MACE within 30 days. In the low-risk group, as per the SVEAT score, 6 (0.7%) patients experienced MACE, whereas in the low-risk group, based on the HEART score, 8 (1%) patients experienced MACE. The SVEAT score demonstrated an Area Under the Curve (AUC) of 0.916 (95% CI 0.890 to 0.942), surpassing the HEART score’s AUC of 0.856 (95% CI 0.822 to 0.890). Sensitivity for the SVEAT and HEART scores was 94.7% (95% CI 88.9%–98.0%) and 93.0% (95% CI 86.7%–96.9%), respectively, with specificities of 84.1% (95% CI 81.0%–86.6%) and 53.17% (95% CI 49.3%–56.6%).

The SVEAT score demonstrated superior predictive accuracy for identifying patients at low risk for MACE compared to the HEART score in the study cohort. Further validation studies are warranted to establish its robustness and applicability in emergency department settings for chest pain risk stratification.

Reference: sciencedirect.com/science/article/abs/pii/S0735675724001049